Individual
BRADLEY ALLWIN MCDONALD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
819 ASH ST, SPOONER, WI 54801-1201
(715) 635-2111
Mailing address
14724 480TH AVE, MILBANK, SD 57252-5925
(605) 432-5852
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
30546
IA
207Q00000X
Family Medicine Physician
Primary
39414-020
WI
207Q00000X
Family Medicine Physician
40575
MN
207Q00000X
Family Medicine Physician
4366
SD
207Q00000X
Family Medicine Physician
9796
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32456200
—
WI
Enumeration date
05/15/2006
Last updated
07/08/2007
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